To assess the clinical manifestation of kerosene pneumonia, we studied20cases with accidental ingestion of kerosene, admitted to the Department of Pediatrics, Kitasato University Hospital in these15years from1983to1998.
All cases were divided into two groups by presence of the positive radiological findings on chest X-ray on admission. Eight patients showed some positive radiological findings, and the remaining cases (n=12) did not have abnormal findings on chest X-ray. We compared several points between these two groups as follows, (1) clinical symptoms on admission, (2) results of arterial blood gas analysis, (3) the time which took from ingestion to confirmation of positive radiological findings, (4) ¹³³Xe ventilation scintigraphy and (5) treatment options.
There were no significant differences on clinical symptoms on admission nor results of arterial blood gas analysis between these two groups. In5cases, secondary chemical pneumonia appeared over 12 hours after kerosene ingestion. In 2cases, ¹³³Xe ventilation scintigraphy revealed impaired lung function after resolution of clinical symptoms and chest X-ray findings.
These results suggest that closed observation in the hospital and sequencial radiological evaluation are necessary in the cases of accidental ingestion of kerosene. And functional evaluation, e.g., ¹³³Xe ventilation scintigraphy, is important after resolution of clinical symptoms and chest X-ray findings.

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We reported a case of infant was noted respiratory and sucking distress that have diagnosed congenital nasal stenosis without treatment. Since nasopharyngeal tube was retained for the treatment, respiratory distress was soon improved and body weight increased. Three months after the retaining, fiberscopic examination and head CT scan were performed. The improvement of stenosis associated with the development of nasal bone and maxilla was confirmed, and nasopharyngeal tube was discontinued.
We conclude that the treatment of retaining nasopharyngeal tube is an effective method for conservatice therapy of congenital nasal stenosis.

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The right middle lobectomy for bronchiectasis in common variable immunodeficiency (CVID) was performed because of the difficulty of medical therapy. Patient has been followed up four years after surgery. Her symptoms and quality of life have been improved. This case showed that surgical treatment for the bronchiectasis in CVID was effective when pulmonary suppuration was intractive and progressive due to localized infected lesion.

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To explore the relation between vitamin A and lower respiratory infection caused by respiratory syncytial virus (RSV) confirmed by antigen test and (or) viral culture, we studied 46cases of bronchiolitis with RSV infection and26controls . Serum vitamin A level of46 patients during acute illness (day 0, 7), convalescence (day 15) and of control infants were measured. Serum vitamin A level between mild and severe patients (Lowell's criterion) was also compared. The results showed that serum vitamin A level at acute stage, convalescence of illness and controls was0.94±0.15μEmol/L, 1.38±0.30μmol/L and1.47±0.30μmol/L, respectively. Twelve severe cases out of 20 (60%) had serum vitamin A level below the mean minus2SD of the value of control infants, whereas only5mild patients out of 26 (19.2%) had vitamin A level below such value (χ²=8.06, p<0.01). The results of this study indicate that serum concentration of vitamin A decreases at acute stage of illness and is spontaneously recovered at convalescence. The degree of the decrease in serum vitamin A at acute stage of bronchiolitis was associated with the severity of illness.

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